Abstract

To THE EDITOR: In four series evaluating recombinant tissue plasminogen activator (rTPA) treatment in acute myocardial infarction, no major events of the central nervous system were reported (1, 2). We report the case of a patient with infarction of the right cerebral hemisphere and its probable mechanism after administration of rTPA.

A 42-year-old man had chest pain and showed electrocardiographic changes consistent with a diagnosis of anterior wall myocardial infarction. Recombinant tissue plasminogen activator was administered per standard protocol. Acute coronary angiography showed almost total occlusion of the left anterior descending coronary artery, with opening during the procedure and two